Cardiac Magnetic: instructions for use,indications, contraindications

Update: October 2018

Cardiomagnyl is an anti-inflammatory drug.
(nonsteroidal), an antiplatelet agent that is used to
prevention of thrombosis and acute cardiac
insufficiency in patients with certain diseases of the cardiovascular system
or risk factors that increase the complications of these diseases.

Anti-inflammatory effects of the drug are associated with irreversible
inhibition of cyclooxygenase-1 by acetylation and blocking
formation of thromboxane A2. All this leads to the suppression of aggregation
platelet blood cells, and therefore, prevention
thrombosis.

The drug is well established in the practice of cardiology.
and is vital to many patients, warning
severe complications of cardiovascular diseases.

Фармгруппа: НПATП, антиагреганты.

Composition, physico-chemical properties, price

Available in white oral tablets.
specific shape in the form of hearts. Covered with a film shell.

The composition of cardiac on 1 tablet:

  • Main substance: acetylsalicylic acid -75 mg, magnesium
    hydroxide – 15.2 mg. Form of the drug “forte” contains 2 times
    a large dose of active ingredients: acetylsalicylic acid – 150
    mg, magnesium hydroxide – 30.39 mg.
  • Excipients: magnesium stearate, corn starch and
    potato, microcrystalline cellulose.
  • The composition of the shell: hypromellose, propylene glycol, talc.

Available in bottles of brown glass of 30 and 100 table.
Price:

  • 75 mg № 100 – 200-250 rubles,
  • 150 mg № 100 – 300-400 rubles.

pharmachologic effect

Cardiomagnyl is characterized by pronounced antiaggregant
action. All known acetylsalicylic acid, which is part of
the composition of the drug in large doses (500 mg – the average therapeutic
dose for an adult) has a pronounced anti-inflammatory
effect, eliminates pain, inflammation and fever. AT
small doses interferes with the gluing of platelets, the formation of
blood clots, and also has a mild anti-inflammatory effect:

  • irreversibly inhibits cyclooxygenase-1, participating in
    the formation of prostaglandins that trigger the inflammatory response in
    the body;
  • inhibits thromboxane A2 synthesis in platelets, warning
    thus their aggregation (bonding).

To achieve these effects, the drug should be used.
for a long time, in recommended doses.

Magnesium hydroxide has a protective effect on the gastrointestinal mucosa and
защищает ее от действия acetylsalicylic acid.

Pharmacokinetics

Acetylsalicylic acid (ASA) is fully absorbed from
Gastrointestinal tract. The hydrolysis reaction to salicylic acid is carried out at
hepatic esterases in the liver as well as in blood plasma and
intestine. The half-life of ASA is about 15 minutes, and the salicylic
acid about 3 hours. Additional reception of ASC (above 3 g)
is able to lengthen the half-life of the metabolite (salicylic
acid) due to the absolute saturability of enzyme systems.

Salicylic acid bioavailability is 80-100%, i.e. is an
high. Bioavailability of ASA varies by 70%, but
may be altered by presystemic hydrolysis in the gastric
wall, as well as in the intestines and liver. It is very important that hydroxide
magnesium in no way affects the bioavailability of ASA.

Indications

Indications к применению кардиомагнила следующие:

  • Primary prevention of diseases of the heart and blood vessels – thrombosis
    and heart failure of acute nature against the background of factors
    risk: diabetes, hypertension, hyperlipidemia,
    obesity, smoking, old age;
  • Prevention of recurrent myocardial infarction and thrombosis
    blood vessels;
  • Prevention of thromboembolism after operations on
    vessels: coronary artery bypass surgery, coronary angioplasty
    (transluminal);
  • Angina unstable.

Contraindications

AT инструкции по применению кардиомагнила указаны следующие
restrictions on use:

  • Hemorrhage in brain tissue;
  • Propensity to bleed on the background of vitamin K deficiency,
    hemorrhagic diathesis, thrombocytopenia;
  • Erosive and ulcerative pathologies of the gastrointestinal tract in the acute phase;
  • Gastrointestinal bleeding;
  • Bronchial asthma induced by salicylate treatment and
    НПATС;
  • Тяжелая степень дисфункции почек (КК<10 мл/мин);
  • The deficiency of the enzyme glucose-6-phosphate dehydrogenase;
  • Simultaneous treatment with methotrexate at a dose of more than 5 mg per
    a week;
  • 1, 3 trimesters of pregnancy;
  • Lactation;
  • Children’s age up to 18 years;
  • Hypersensitivity to ASA, additional substances in the composition
    препарата и иным НПATС.

Contraindications кардиомагнила ни в коем случае нельзя
ignore – negative reactions from the body are
serious and even life threatening.

special instructions

With care and under the supervision of a physician, the drug is prescribed in
following cases:

  • hyperuricemia;
  • ulcerative lesions of the gastrointestinal tract or bleeding from the gastrointestinal tract in history;
  • gout;
  • renal or hepatic failure;
  • bronchial asthma;
  • hay fever;
  • allergic conditions;
  • nasal polyposis;
  • 2 trimester of pregnancy.

It should be remembered that acetylsalicylic acid can cause
bronchospasm, asthma attacks and other reactions
hypersensitivity.

Also, the active ingredient may cause bleeding during and
after operations. Therefore, before the operation, the attending physician should conduct
assessment of the risk of bleeding compared with the risk of ischemic
complications in patients undergoing cardiogram treatment and
Based on this, decide to cancel the drug or
the continuation of his reception. More should be remembered that acetylsalicylic
acid in combination with thrombolytics, anticoagulants and
antiplatelet drugs are also characterized by increased
risk of bleeding.

Drug treatment may trigger the development of gout in
patients who have a predisposition to the disease (with reduced
excretion of uric acid).

AT сочетании с метотрексатом (даже в низких дозах) отмечается
increased incidence of side effects from
hematopoietic system.

ATысокие дозы АСК оказывают гипогликемическое действие, поэтому
hypoglycemic patients with diabetes
medication internally and receiving insulin should be careful
during treatment.

Unauthorized overdose of the drug directly increases the risk
развития кровотечений из Gastrointestinal tract.

With long-term drug treatment should be careful
elderly patients – the risk of bleeding from the gastrointestinal tract in
this age group is always higher.

ATо время лечения не следует принимать алкоголь, поскольку это
also increases the risk of damage to the gastrointestinal mucosa, and in the case of
development of bleeding increases its duration.

AT период лечения кардиомагнилом рекомендуется соблюдать
caution while driving while potentially
hazardous activities and jobs requiring high concentrations
attention.

Dosage

Tablets need to be swallowed whole, drink water. If a
swallowing difficult, you can break the tablet in half or
grind to powder.

  • Primary prevention of cardiovascular disease: thrombosis, acute cardiac
    deficiency against the background of the above risk factors in the first
    a day is prescribed a tablet “forte” 150 mg (or 2 to 72 mg) per
    a single dose, and then proceed to a dose of 75 mg once a day.
    day (conventional tablet cardio);
  • Prevention of recurrent myocardial infarction and thrombosis: по 1
    a tablet of 75 or 150 mg once a day. Dose is chosen
    individually;
  • Prevention of thromboembolism after surgery on
    сосудах: по 1 a tablet of 75 or 150 mg once a day. Dose
    подбирается individually;
  • Unstable angina: also 1 tablet 75 or 150 mg
    once a day. Dose is chosen индивидуально.

Overdose

Overdose препарата может быть средней и тяжелой степени
gravity.

The clinical picture of a moderate overdose: vomiting,
nausea, hearing loss, tinnitus, confusion and
dizziness. Treatment includes gastric lavage, taking
adequate doses of activated carbon and other drugs for
symptomatic therapy depending on the clinic.

The clinical picture of a moderate overdose:
hyperventilation, fever, respiratory alkalosis, ketoacidosis,
coma, respiratory and cardiovascular failure,
severe hypoglycemia. Treatment without fail
implies immediate hospitalization for emergency
therapy in the intensive care unit and includes: introduction
alkaline solutions, conducting gastric lavage, forced and
alkaline diuresis (for blood pH to be 7.5-8), hemodialysis, and
use of other drugs for symptomatic therapy.

Side effects

Side effects of cardiomagne may be noted by
different systems:

  • Allergic phenomena: urticaria often occurs, a little less –
    angioedema, and rarely can anaphylactic reactions develop
    type right up to shock.
  • On the part of the gastrointestinal tract: very often patients note heartburn, often
    nausea and vomiting occurs. Sometimes there is pain in
    ulcers on the mucous membrane of the stomach and
    12перстной кишки, а также кровотечения из Gastrointestinal tract. Quite rare but
    nevertheless, cases of perforation of gastric ulcer or 12
    guts, increased liver enzymes. AT самых редких случаях
    possible stomatitis, erosive changes in the upper GI tract,
    esophagitis, colitis, strictures, irritable bowel syndrome.
  • On the part of the respiratory system often develops bronchospasm.
  • From the blood-forming organs: increased bleeding
    celebrated very often; rarely – anemia. Hypoprothrombinemia,
    neutropenia, thrombocytopenia, aplastic anemia, eosinophilia,
    agranulocytosis develop very rarely.
  • CNS: dizziness, drowsiness are observed in a number of
    cases. Often, patients report headache and sleep disturbance.
    insomnia. Rarely tinnitus and very rarely –
    intracerebral hemorrhage.

Drug interactions

Cardiomagnyl enhances the effect of the following drugs when
simultaneous treatment:

  • methotrexate – by reducing renal clearance and extrusions
    its due to protein;
  • indirect anticoagulants and heparin – by changing the function
    тромбоцитов и extrusions антикоагулянтов из связи с
    proteins;
  • thrombolytic and antiplatelet drugs,
    for example, ticlopidine;
  • hypoglycemic agents oral and insulin
    similar mechanism;
  • digoxin, causing a decrease in its renal excretion;
  • valproic acid, displacing it from its association with proteins.

In combination with ibuprofen, cardioprotective effects are reduced.
acetylsalicylic acid.

When taking cardiomagnyl with drugs containing ethanol,
the effect of both drugs is enhanced.

Action urikozuricheskih funds against the background of taking cardiomagnyl
decreased due to tubular competitive elimination of urinary
acid.

Enhancing the elimination of drugs-salicylates, systemic corticosteroids
weaken their effects.

With simultaneous treatment with antacids and Kolestiramine
снижается всасывание acetylsalicylic acid.

Thromboass or cardiogram?

What is better: thromboass or cardiomagnyl? This question is asked by many
Patients. Let’s try to figure it out.

One of the most significant benefits for the patient, it is lower
the price of the drug thromboass: a pack of 100 tablets at a dosage of 100
mg will cost 120-180 rubles. However, cardiac tablets
belong to the group of available drugs, and given that
the fact that you need to take it once a day will not hit hard
wallet

Drugs are interchangeable: have
almost identical indications, contraindications and side
effects. The active ingredient is the same – acetylsalicylic
acid, only in different dosages. So, cardiomagnyl contains 100
or 150 mg of ASA, and thromboass – 50 or 100 mg. Proved exactly
small doses of ASK have an antiplatelet effect, therefore, in this
Both drugs will be effective.

The drug cardiomagnet contains the second active ingredient –
magnesium hydroxide, which protects the gastrointestinal mucosa from negative
effects of ASC. Thromboass does not contain such a component, however
has a special membrane that does not dissolve in the stomach under
the action of hydrochloric acid and is absorbed already in the duodenum.
However, not all patients are for health reasons or other reasons.
able to swallow the tablet whole, and when chewed
the protective properties of the shell are already lost. In addition, even with
swallowing the tablet completely, the ASA does not act only on the mucous membrane
stomach, whereas in the 12th colon, it is already absorbed, whereas
many patients have a combined ulcerative lesion of the stomach, and
Duodenum.

Cardiomagnyl feedback is mostly positive.
effects, as a rule, develop only in persons with burdened
history.

In each case, the choice remains for the doctor and patient.
Both thromboass and cardiogram have benefit and harm and are not
100% safe. Meanwhile, the risk of side effects,
especially serious, always less risk of dangerous diseases of the CAS,
which each patient has (the history of which is burdened
risk factors), not taking antiplatelet.

Analogs

Tromboass: price 120-180 rubles. 100 tablets of 100 mg; Aspirin cardio: price 230-250 rubles. for 56 tablets of 100 mg; Trombopol: the price of 21-60 rubles. for 50 tablets of 150 mg; Aspicor: price 50-60 rubles. for 30 tablets of 100 mg.

Автор: врач-гигиенист, эпидемиолог

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